This is a resubmission of a proposal by University of Wisconsin's Center for Health Systems Research and Analysis (CHSRA) that originally responded to PA-00-138. This research, now in collaboration with the University of Wisconsin's Pediatric Asthma Clinical Research Program, will test whether and how a Web-based telehealth nursing care support system can increase asthma symptom-free days and adherence to asthma controller medication of children, age 5-12, with moderate persistent or severe persistent asthma. CHESS (Comprehensive Health Enhancement Support System), the proposed intervention, will integrate monthly telephone nurse care management through several healthcare organizations into its existing services. This will allow families to share asthma data with the nurse and the nurse to create educational links within CHESS to help pediatric patients and families gain mastery in asthma self care. Our secondary aims include testing whether CHESS (with the case management feature) improves lung function and parent and child quality of life, and reduces unplanned asthma-related healthcare utilization, missed days from work and school due to the child's asthma. Furthermore, we will examine a mediational model that should help explain the mechanism by which CHESS has its effects. This will be a community wide implementation and will include Madison's four managed care organizations, Deancare, Physicians Plus, Group Health Cooperative, and Unity. A broad campaign will be used to increase participation by ethnic minorities. 400 children with asthma and primary parent will be recruited; one-third of the sample will be ethnic minorities. Subjects will be randomized to receive Standard Care or CHESS (with case management). Six data sources will be used: 1) Claims data for pharmacy refills, 2) spirometry, 3) self-administered survey questionnaire, 4) Doser to electronically measure rescue inhaler medication, 5) monthly telephone interview, and 6) CHESS usage data. Spirometry and survey data will be collected in the home at 0, 3, 6, 9 and 12 months. Nursing care management and CHESS have both been shown to have positive outcomes in chronic disease management, however this is the first opportunity to study them in combination.